Impact of metabolic syndrome on the outcome of patients with stable coronary artery disease: 2-year follow-up of the MASS II study.
OBJECTIVE
We characterized the impact of the metabolic syndrome (MetS) and its components on cardiovascular adverse events in patients with symptomatic chronic multivessel coronary artery disease, which have been followed prospectively for 2 years.


METHODS
Patients enrolled in the MASS II study were evaluated for each component of the MetS, as well as the full syndrome.


RESULTS
The criteria for MetS were fulfilled in 52% of patients. The presence of MetS (P<0.05), glucose intolerance (P=0.007), and diabetes (P=0.04) was associated with an increased mortality in our studied population. Moreover, despite a clear tendency for each of its components to increase the mortality risk, only the presence of the MetS significantly increased the risk of mortality among nondiabetic study participants in a multivariate model (P=0.03, relative risk 3.5, 95% confidence interval 1.1-6). Finally, MetS was still associated with increased mortality even after adjustment for diabetes status. These results indicate a strong and consistent relationship of the MetS with mortality in patients with stable coronary artery disease.


CONCLUSIONS
Although glucose homeostasis seems to be the major force driving the increased risk of MetS, the operational diagnosis of MetS still has information for stratifying patients when diabetes information is taken into account.
Lopes
Neuza H
NH
Heart Institute (InCor) of the University of Sao Paulo, Sao Paulo, Brazil. mass@incor.usp.br
Paulitsch
Felipe S
FS
Pereira
Alexandre C
AC
Góis
Aécio F
AF
Gagliardi
Antônio
A
Garzillo
Cibele L
CL
Ferreira
João F
JF
Stolf
Noedir A
NA
Hueb
Whady
W
D001786:Blood Glucose / Q000378:metabolism; D001938:Brazil / Q000453:epidemiology; D016001:Confidence Intervals; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications* / Q000401:mortality; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
D001786:Blood Glucose